Sunday, April 5, 2020

CDC Report: Coronavirus Mortality Rates in US Increase Dramatically by Age Group

A report released by the Centers for Disease Control (CDC) last week showed that coronavirus mortality rates in the United States increase dramatically by age group.

The data in the report, “Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) — United States, February 12–March 16, 2020,” included data from 2,499 new coronavirus cases where the age and hospitalization status of the patient were known, out of 4,266 total new coronavirus cases reported during that time period.

Forty-four of these 2,499 patients died. None of those who died were under the age of 20, nine were adults aged 20 to 64, 20 were adults aged 65 to 84, and 15 were adults aged 85 and older. (Note: 87 Americans died of coronavirus by March 16, Worldometers reported, meaning only slightly more than half of those deaths were included in this CDC study.)

Here is how that broke down as a mortality rate by specific age group when the total number of deaths in the age group is the numerator and the total number of cases in the age group is the denominator:

  • 0 percent for those aged 0 to 19 (an age group that accounted for 5 percent of those included in the study, or 123 out of 2,449)
  • 0.1 percent for those aged 20 to 44 (an age group that accounted for 29 percent of those included in the study, or 705 out of 2,449)
  • 0.5 percent for those aged 45 to 54 (an age group that accounted for 18 percent of those included in the study, or 429 out of 2,449)
  • 1.4 percent for those aged 55 to 64 (an age group that accounted for 18 percent of those included in the study, or 429 out of 2,449)
  • 2.7 percent of those aged 65 to 74 (an age group that accounted for 16 percent of those included in the study, or 409 out of 2,449)
  • 4.3 percent of those aged 75 to 84 (an age group that accounted for 8 percent of those included in the study, or 210 out of 2,449)
  • 10.4 percent of those aged 85 and older (an age group that accounted for 6 percent of those included in the study, or 144 out of 2,449)

The CDC study referred to these mortality rates as a lower bound, because they used the total number of cases in each age group as the denominator. It also included data on what it considered an “upper bound” for mortality rates when the denominator referred only to “cases with known information on each outcome.”

Using these “upper bound” denominators, the mortality rates increased in each age group, ranging from 0.2 percent in the 20 to 44 age group all the way up to 27.3 percent in the 85 and older age group.

The report added:

[Between February 12 and March 16], 4,226 COVID-19 cases were reported in the United States; 31% of cases, 45% of hospitalizations, 53% of ICU admissions, and 80% of deaths occurred among adults aged ≥65 years with the highest percentage of severe outcomes among persons aged ≥85 years.

These findings are similar to data from China, which indicated >80% of deaths occurred among persons aged ≥60 years (3). These preliminary data also demonstrate that severe illness leading to hospitalization, including ICU admission and death, can occur in adults of any age with COVID-19.

In contrast, persons aged ≤19 years appear to have milder COVID-19 illness, with almost no hospitalizations or deaths reported to date in the United States in this age group. Given the spread of COVID-19 in many U.S. communities, CDC continues to update current recommendations and develop new resources and guidance, including for adults aged ≥65 years as well as those involved in their care

In an exclusive interview with Breitbart News on Tuesday, Secretary of Health and Human Services Alex Azar highlighted the significance of mortality rates in the president’s plans to re-open the country for business:

The data that the president and his team of doctors and scientists will consider as they make their decision on reopening America, Azar said, is most importantly mortality rates of the disease—but also infection rates and other data.

“Dr. Birx said yesterday at the press conference the most important data point you look at that is essentially irrefutable is mortality data,” Azar said. “How many people are dying from Covid-19? That will be your firmest bit of data in assessing the situation. You will also look at infection rates and new cases, but the problem there is you never can test everybody. So the testing gives you an indicator and gives you a trend, but it is certainly less secure information than mortality data that you would look at.”

Trump, later on Tuesday after Azar’s interview with Breitbart News, said during a Fox News town hall that he hopes to reopen much of the United States by Easter Sunday, April 12. Trump, with Dr. Birx standing alongside him on Monday evening in the White House briefing room, began signaling the reopening of the country. He seems to have an ally in New York’s Democrat Gov. Andrew Cuomo, who has also voiced support for reopening the country.

The notion that public policy and government actions should be influenced by the differing mortality rates by age groups has been advanced recently by several doctors and scientists, including Dr. David L. Katz, president of True Health Initiative and the founding director of the Yale-Griffin Prevention Research Center, who set forth this argument in an op-ed published in the NewYorkTimes last week:

The clustering of complications and death from Covid-19 among the elderly and chronically ill, but not children (there have been only very rare deaths in children), suggests that we could achieve the crucial goals of social distancing — saving lives and not overwhelming our medical system — by preferentially protecting the medically frail and those over age 60, and in particular those over 70 and 80, from exposure.

Why does this matter?

I am deeply concerned that the social, economic and public health consequences of this near total meltdown of normal life — schools and businesses closed, gatherings banned — will be long lasting and calamitous, possibly graver than the direct toll of the virus itself. The stock market will bounce back in time, but many businesses never will. The unemployment, impoverishment and despair likely to result will be public health scourges of the first order.

As President Trump develops his plans to re-launch the economy in the near future as the coronavirus pandemic continues, mortality rates by age group will likely be key facts under consideration by both public health experts and economists.

Michael Patrick Leahy

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